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Clinical Case Studies
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Sequential Parent Management Training and Cognitive-Behavioral Therapy for a Child With Comorbid Disruptive Behavior and Obsessive Compulsive Disorder

Heather D. Lehmkuhl

Nationwide Children's Hospital, Columbus, Ohio

Eric A. Storch

University of South Florida, St. Petersburg

Omar Rahman

University of South Florida, St. Petersburg

Jennifer Freeman

Brown Medical School, Providence, Rhode Island

Gary R. Geffken

University of Florida, Gainesville

Tanya K. Murphy

University of South Florida, St. Petersburg

Psychiatric comorbidity is common in pediatric patients with obsessive-compulsive disorder (OCD) and may negatively affect treatment outcome. In particular, comorbid disruptive behavior disorders have been associated with attenuated treatment response in youth undergoing cognitive-behavioral therapy (CBT) for OCD. This article presents the case of a 10-year-old female with a primary diagnosis of OCD and secondary diagnosis of oppositional defiant disorder who was successfully treated with parent management training (PMT) prior to initiation of CBT. PMT was effective in reducing oppositional behaviors and resulted in improved adherence to the treatment protocol. The current report provides preliminary evidence for the effectiveness of PMT in youth with OCD and comorbid disruptive behavior. Clinical recommendations are provided to foster improved outcomes in this population.

Key Words: obsessive-compulsive disorder • disruptive behavior disorder • patent management training • cognitive-behavioral therapy

Clinical Case Studies, Vol. 8, No. 1, 48-58 (2009)
DOI: 10.1177/1534650108326786
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